Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Owen Gillam

Individual provider Physical Therapist · NPI 1508413469

Owen Gillam is a Physical Therapist in Private Practice in Herkimer, New York. Qualified in 2019, 7 years ago. Licensed in Florida.

Years since qualifying
7
Licensed in
FL
In the registry since
2019
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Practice location Address checks out

3061 State Route 28
Herkimer, NY 13350-1041
Phone: (315) 717-0020
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT41539 (FL)

Record details

NPI number1508413469
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 24, 2019
Last updated in NPPESFebruary 10, 2026
Certification dateFebruary 10, 2026
Mailing address3061 State Route 28, Herkimer, NY 13350-1041

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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